C-section recovery: What to expect in the days after a Cesarean delivery

How painful will the incision be? And when will I be able to get up and walk? Here's what to expect in the days and weeks following a C-section delivery.

Photo: iStockPhoto

For Vanessa Tantalo, a Brampton, Ont.-based interior designer, the days and weeks after giving birth to her son via an unplanned Cesarean section were…not fun. In addition to feeling disappointed that she wasn’t able to have a traditional delivery, Tantalo was in a lot of discomfort and felt isolated. “Since you’re only allowed to lift the baby or the carrier—but not both—I wasn’t able to go out by myself for six weeks,” she says.

Aly Tyghter, a nutrition expert in Brampton, Ont., had a similarly negative experience when she delivered her daughter via unplanned C-section in 2013. “My recovery was awful,” she says. “I didn’t have any complications, but I just wasn’t fully prepared for how difficult it would be to function with a scar across my pelvis.” Tyghter also found breastfeeding difficult because she couldn’t twist to get the baby out of her bassinet, or lift her easily. “Even walking was hard.”

After a steady decline from the mid-80s to the mid-90s, there’s been a rise in the rate of C-sections in Canada, from 19 percent of all births in 1997 to 27.5 percent in 2014 and if you live in some provinces, the rate is even higher: as of 2014, 30 percent of births in PEI are C-sections, as are almost 34 percent in BC.     A mom after a c-section    
   C-section procedure: What to expect with a Cesarean delivery

Both Tantalo and Tyghter say their experiences would have been better if they’d known what to expect. If you’re planning on delivering via C-section (and even if you’re not), here’s what you need to know to make your recovery easier.

Preparation is key for C-section recovery

Nathalie Pambrun, a midwife in Winnipeg, recommends preparing a “comfortable nest” for when you come home from the hospital. It could include diapering supplies, snacks, water, a breastfeeding pillow—and a phone within easy reach. If you live in a two-storey house, keep essentials on both floors to minimize stair climbing and line up friends and family who can help out with household tasks like laundry, cleaning and dishes.

When you’re packing your hospital bag (here’s what to put in your suitcase if you’re having a C-section), consider adding cranberry juice to reduce the risk of a catheter-induced UTI, as well as chewing gum or molasses, which Pambrun says can help restore bowel function faster.

You may also want to stock up on some high-waisted underwear. “Doctors make the scar low enough that an underwear line hides it, but what they don’t tell you is that it is exactly at your underwear line if you’re not wearing granny panties!” says Tyghter. “I had to go out and buy underwear that came up to my belly button instead of my bikini line because having anything rub up against the scar was dreadful.”

What to expect after a C-section

After a C-section, you’ll probably have to stay in the hospital for three days and, even when you’re released, you’ll need to take it easy. For most moms, it will take four to six weeks to make a full recovery. Here’s what to expect during that time:

1 day later: You’ll be encouraged to walk around within the first 12 hours after delivery to help relieve gas buildup in the abdomen, and to eat something light as soon as you feel able.

2 days later: By now, you’ll be able to shower as usual. Your bowel movements may not be regular right after surgery, which is very common and the reason doctors often recommend trying a stool softener. Eating fibre-rich foods and drinking lots of water will also help.

3 days later: It often takes longer for your milk to come in after a C-section than after a traditional delivery, especially if you weren’t labouring before surgery, but your mature milk should be in by about day three or four (prior to this, the baby will get colostrum).

1 week later: You’ll probably be feeling better physically, but it’s important not to overdo it. Remember not to lift anything heavier than your baby. And that the old adage about sleeping when the baby sleeps is worth following—getting enough rest is essential to healing.

4 to 6 weeks later: Your pain should be minimal, if not completely gone, so it’s likely you’ll be able to ease into doing more strenuous activities—like driving, exercise and, yes, sex—but don’t start without your doctor’s OK.

How to deal with C-section pain

“Most women don’t need much more than a combination of Tylenol and an anti-inflammatory like Advil or Motrin,” says Jessica Dy, an OB-GYN at The Ottawa Hospital. A small number will need narcotics, especially immediately following surgery. “When anesthesiologists give a spinal or epidural for the C-section, they’re really good about giving a good, long-lasting pain medication that lasts for 12 hours after the surgery, because that time frame is really the worst for women.” But, she adds that you should take your painkillers every four hours around the clock to try to stay ahead of the soreness, and that you can ask your doctor for something stronger if you’re in a lot of pain. Hold a pillow over your incision when coughing or taking deep breaths, or consider a postpartum support belt, which reduces the strain on your abdominal muscles.

Caring for your C-section incision

Be sure to wash your incision daily with warm, soapy water—but don’t use hydrogen peroxide, which can slow healing. And make sure you keep it dry the rest of the time. Doctors often recommend patting the incision gently with a towel after bathing, but Tantalo found it easier to use a hair dryer on the cool setting. “The main complication we’re looking out for is infection,” says Dy. Watch for increased pain, swelling, warmth or redness, red streaks leading from the incision, pus, swollen lymph nodes or fever; call your doctor immediately if you notice any of these symptoms.

Can you have a vaginal birth next time?

Barring any complications, you’ll likely be able to have a traditional birth—known as a vaginal birth after Cesarean, or VBAC—in the future. If a woman had a straightforward C-section and there were no complications (like extension of the incision or uterine rupture), and there are no complications for the second pregnancy (like placenta previa), there’s no reason not to consider labour the next time around, says Dy.

Read more:
How to have a gentler C-section
Why you shouldn’t shave down there before labour

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